The COVID-19 pandemic is now a global problem that has significantly impacted the safe practice of maxillofacial surgery. It is important to compile information and experiences that have been gained by colleagues worldwide and define a set of guidelines for best practices for staff performing these procedures, and for patients undergoing maxillofacial surgery procedures. As such these recommendations should be treated as “expert opinion” and are mostly based on personal communication, guidelines put forth by various national and international societies, and peer-reviewed data when possible.
It is clear that surgical procedures involving the nasal-oral-endotracheal mucosal regions are high risk due to aerosolization of virus which is known to be in high concentration in these areas when compared to swabs from the lower respiratory tract. Further it appears that if viral particles become aerosolized, they stay in the air for at least 3 hours, if not longer. Procedures should be limited to those involving emergent airway management, epistaxis, surgical management of facial fractures which require ORIF, and oncologic procedures in which a delay in management could affect ultimate outcome. Consideration should be given to limiting patient contact in surgeons that are over 60 years of age, are immunosuppressed, have chronic pulmonary disorders, or multiple co-morbidities. The number of residents and ancillary staff should be limited as much as possible. Proper PPE and training for all members of the team is required.
In this webinar specific recommendations for Airway Management, CMF Trauma and Oncologic Care are reported. This is an evolving and constantly changing situation, and these recommendations are based on the best available information at this time. Please remember, these are recommendations and not mandates and ultimately the decision of the treatment of patients still rests with the individual practitioner. Our primary goal is to provide safe and effective treatments for our patients, while minimizing the risk to the practitioner as much as possible.
